- "This episode of "The Good Doctor" is a made up story
about a real battle still being fought.
Honor the heroes, doctors, nurses,
and other frontline workers,
many of whom who have given their lives.
Do your part, wear a mask."
Great message.
(woman coughing)
I love the way they're showing the viral particles.
They're just spreading out everywhere.
That absolutely does happen.
That's why it's really important to dab
when you cough to try and limit that spread.
We've seen it actually spray six feet away from you
when you cough or sneeze.
And germs have hang time.
So you can walk into an empty room
that someone just sneezed it and be exposed to those germs.
I don't know why I did that.
(dramatic music)
- And there you go.
- This is such a good example of how germs spread,
droplets, meaning someone coughs or sneezes or speaks.
Contact, meaning they coughed on their hands
and they touch something, they give it to somebody else.
When we talk about disinfecting your hands, wearing a mask,
we're talking about decreasing droplet spread
and contact spread.
- Have you seen my ID badge? - No.
- I had it last night,
but maybe it fell out of my bag.
- I lose my ID badge all the time.
Like not permanently lose it, but have it in my car,
in my trunk, in my suitcase, in my home.
Sometimes Bear steals it.
Sorry, Bear.
- Your temperature's almost 101.
Your other symptoms?
- First, it was a sore throat.
Then my body started aching.
(coughing)
And then there's this cough.
I even had my flu shot.
- Unfortunately, influenza is constantly mutating.
The shot always lags behind.
- Both very accurate statements.
In fact, during this timeframe in February,
I was working in my primary care office.
We knew COVID was around,
but we didn't think it was everywhere yet.
So a lot of patients were coming to my practice
with upper respiratory viral symptoms, just like this.
Fever, cough, muscle aches
and we thought they potentially had influenza.
We gave them antivirals for influenza.
The reality is even if you had your flu shot,
you can still get the flu, but your case should be milder.
- My daughter is very worried that I might have this virus
from China, what's it called?
- Have you been to China or been around anyone
who's been to China recently?
- Those are the questions we were asking.
At that time, I think we were referring
it to NCOV-19, right?
Was it NCOV-19?
(woman coughing)
- The virus has damaged your mother's lungs.
Her body is working harder and harder to breathe,
but her blood oxygen levels continue to drop.
- She definitely has corona?
- We're doing everything we can to help her.
(dramatic music)
- See that patient was actually
in a negative pressure air room.
They were isolated from other people
because at that point we were deciding whether COVID-19
was only needed to maintain a droplet precaution
where you just cover your face
and the patient's face with a mask,
or do we need negative pressure room?
Because COVID was spread to airborne transmission
where the virus just lived in aerosolized particles
in the air all the time.
And what we came to realize is
it's more of a droplet spread,
but there are some instances where it can be spread
through aerosolized particles,
especially during medical procedures like intubations.
- You have COVID.
(man sighs)
- Okay, now what?
- Now you go home,.
- That's it? - That's it.
There's no treatment.
Stay away from people.
Come back if you have trouble breathing, goodbye.
- I forget 'cause I don't watch this show regularly
how funny Shaun is.
COVID-19 is a viral illness.
So if your oxygen levels are not dropping drastically
and you just kind of feel lousy and you have a mild fever,
your body is the one that has to fight this off.
Like there's very little that we can actually do
in the hospital systems.
And by keeping you in the hospital,
we're actually increasing the risk to healthcare providers
and other patients.
- 25 tests per day?
No, just give me one of tomorrows.
Hello?
County health department, I don't have time for them
And apparently they don't have time for me.
- I remember in March I had a patient
who I suspected to have COVID-19
but I didn't have a test available.
So I was calling the department of health,
trying to secure a test for them.
Eventually getting them a test,
finding out that they were in fact positive.
Luckily everyone was wearing a mask at that point
so we decrease the spread, we cleaned the room,
sent them out the back door,
tried to do our best to limit the spread of this virus.
There's just a lot of things we didn't know in the beginning
that we know now.
- If I'm sick is my baby sick?
- This disease doesn't really seem to affect children
and babies like it does adults.
Should we admit her?
- She's probably safer at home.
- What's at home, do you have a support system?
Can anyone come help you- - Good question.
- In case you get worse?
- It's just me and the little one.
- Good doctors always ask questions like this.
If I'm sending a patient home
that I'm sort of questionable on
and let's say they had a concussion,
I always want to make sure that there someone
to keep an eye on them.
That if they become unconscious,
they have someone to call for help and to check on them.
- If I come home, do you want me living with you?
- [Woman] Of course, that's the point.
- Every night after 12 hours of COVID patients
to hang out with you and Kellan and his asthma?
- Interestingly enough,
we've seen conflicting reports on how COVID-19
affects those with asthma.
Now, if it's just asthma alone,
it doesn't seem to be as bad as we expected it to be.
But those who are asthmatic and have other comorbidities
like heart disease, obesity,
those are the patients that seem to be experiencing
worse symptoms and worse outcomes.
- We do everything we can.
We hammer at official channels
and every manufacturer's rep that we deal with
and see what companies have if any have-
- [Woman] Nuts or no nuts?
- I'm sorry, I'm in the middle of a meeting with the board.
- Hey, everyone!
I'm just baking banana bread.
- One of the most search terms in height of this pandemic
was how to make sourdough bread.
Go figure, I've never made sourdough bread,
I've never Googled it.
I don't know who's sitting at home Googling it,
but apparently sourdough bread
was the thing everyone was making, not banana bread.
- Your husband's blood oxygen level is dangerously low.
- That, that can't be.
- So one of the hallmark symptoms of COVID-19
is decreased oxygen saturation in your blood
where you're actually not getting enough oxygen
from usually the edema or the scarring
that's happening in your lungs
as a result of the inflammation that occurs with this virus.
One of the dangerous parts of COVID-19 is
not only are you infected with this virus
that you're fighting off,
but some people have an overreaction or a cytokine storm
where all these inflammatory cells come to the lungs.
It actually causes a bigger problem
where you can't get enough oxygen going
and being delivered to the rest of your body,
your vital organs, your liver, your kidneys,
your brain and so forth.
Our solution to that was to ventilate,
meaning intubate all these patients.
And as we did that more and more often
without treating them with proper medications
like we have now and we know which ones work,
patients actually got worse on ventilators
because we were over ventilating people.
And it's not because we're stupid
or we were intentionally harming people,
but it was simply because it's a novel virus
and we did not have guidelines
on how to best treat patients with it.
We were learning about it on the go.
- We have a surplus of EKG leads?
- No, we've got a shortage,
but that's a problem that can wait.
- The PBE situation was really dire
in the beginning of this pandemic
because China was hit first
and a lot of our manufacturing facilities are in China.
And because of that,
they actually redirected all their shipments
to their country because they needed them.
And as a result, we're facing a lot of shortages for gloves,
for EKG leads, for swabs, for test kits,
antibacterial wipes, the vials, for injections.
The wiring and the tubing for ventilators.
There were so many shortages that were happening
simultaneously, it was a truly dire situation,
especially here in the New York City area.
(soft music)
Him rubbing his ears like that is from the mask.
Oh my God, in the beginning,
just wearing the mask for countless hours.
My ears heard so much.
I just remember being so sore,
but as we learn to use those little headpieces in the back
where you could actually have the mask stay on there
as opposed to on your ears,
it made the world of a difference.
And for those of you who haven't ever worn an N95 mask,
they're uncomfortable because they offer more protection.
They're more form fitting, you have to get them fit tested,
but they also put a lot of pressure on your face.
They leave marks.
That's why all those pictures
were making the rounds of nurses,
doctors who were having bruising in that area
from just wearing them day in and day out.
And a lot of times they were reusing equipment
that was meant to be disposable.
- You work in a hospital.
- Yes.
- Could you wait for the next elevator?
I appreciate you.
(laughing)
- You know, it's funny.
In New York, if you ever wore your scrubs out
during that period,
everyone wanted to say thank you and was grateful,
and that's amazing.
But at the same time,
everyone wanted to keep their distance.
Rightfully so, I understand you don't want to put yourself
or your family members at risk, but it didn't feel good
that you were being alienated like that.
So it's part of the process.
- My mother is in there all alone,
hooked up to a machine.
I just need to see her and tell her
that I love her.
- There's a human toll that it takes on family members
not being able to see your family member
and if you're the one ill not seeing your family members.
I will also venture to say,
and I don't have evidence for this,
but I will say that hospital errors do go up
if you do not have family members present
and advocating on your behalf,
especially if you're unconscious.
Now, what we've learned from that
is we're trying to keep families more updated,
trying to keep them involved.
If they're not there at the bedside, through virtual care,
giving them scheduled regular phone calls,
because we realize that when we're in better communication
with the family, we actually get better outcomes
for our patients.
(machine flatlining)
- [Nurse] Pushing epi.
- Why is no one doing chest compressions?
I don't understand.
Do some chest compressions. - 120 Joules, clear.
- Do some chest compressions.
- [Nurse] Refib now.
- Did you see those horrible chest compressions?
She just put her hands on the chest, didn't even compress.
- 200 Joules, clear.
- Okay, I don't know why,
these people have high end experts on set.
You start chest compressions
and then you use a defibrillation.
I have heard in the beginning of the pandemic,
'cause I wasn't in the hospitals.
I was seeing patients, outpatient,
that they were decreasing the amount of chest compressions
being done because they were worried about
aerosolizing the virus.
I actually just looked this up from the Red Cross,
performing chest compressions
while wearing proper medical protective equipment,
N95 respirators or how they have the whole body suit on,
still means you should do chest compressions,
like do them, do them, do them.
I don't know why they weren't doing them.
I was trying to make excuses for them.
They should have been doing chest compressions
from the start.
- Any cough? (thermometer beeping)
- Any fever? (thermometer beeping)
- No. - Any shortness of breath?
- Sore throat, loss of smell?
- No, no, none of that.
Just searing abdominal pain and the runs.
I'm pretty sure it's my diverticulitis acting up.
My roommate is deeply into pandemic baking.
I've avoided coming in, I don't want to catch COVID.
- So one of the biggest problems we faced
during this pandemic was patients
not coming into the hospitals.
And in the beginning, when we were really overwhelmed,
that made a lot of sense.
But as we became safer for patients to come in,
we had different policies in place
in order to decrease spread,
our testing improved, our capacity improved,
our PPE improved.
We wanted patients to come back
because a lot of times when patients delay care,
their diseases and conditions get more advanced
and as a result become more difficult to treat.
Patients who are having some signs of heart attacks
were coming in much later and as a result,
some of our mainstay treatments weren't working as well.
And the recoveries took longer.
One of my main messages over the last two, three months
has been to encourage patients
to call their primary care office, to call hospitals,
to come in for the symptoms that are bothering them
and not wait.
- He's pink, active and breathing great.
(baby crying)
(monitor beeping)
- In the midst of our research with COVID-19,
we actually found that there was a limited spread
for mother to fetus of COVID-19 meaning that the mother
could be testing positive for COVID-19.
The baby was usually safe.
Now that doesn't mean there was no spread.
There were some case reports of it happening.
But for the large majority,
we did not want mothers to panic
because it wasn't happening.
And children in general seem to fare better
with this virus anyway.
The numbers of children below the age of 10 dying
with COVID-19 were spectacularly low.
That doesn't mean it's completely benign for them
'cause they could also spread this virus and be vectors.
But it is reassuring for mothers,
especially with the levels of anxiety
that they were facing for themselves.
(somber music)
Please don't put your masks on the floor
and then put them back on your face.
Shaun, you're a doctor buddy.
Don't put it on the floor.
I talked about germs having hang time,
about the hanging out in the air,
but folks, after they hang out in the air
for those minutes or hours, where do they go?
Right on the floor,
especially if you've been walking around a hospital setting
and then you come home with your shoes on,
guess what's on that mask?
Man, couldn't they just have me on set
for one of these things.
Could of help them make it so much more accurate.
My hospital actually created
a state-of-the-art COVID-19 ward.
Check it out as I give you the tour for that
in a day of my life video,
or check out all of my "Good Doctor" reviews
here in a playlist I made just for you.
And as always, stay happy and healthy
and stay alert, not anxious.
(upbeat music)